灾难性医疗需求激增情境下卫生系统韧性评价指标体系构建  

Establishment of an evaluation index system for health system resilience in the context of catastrophic medical surge

作　　者：周文婧 王璐[1] 郭杨 宁宁[1,2] 吴群红 ZHOU Wen-jing;WANG Lu;GUO Yang(College of Health Management,Harbin Medical University,Harbin,Heilongjiang Province 150086,China)

机构地区：[1]哈尔滨医科大学社会医学教研室,黑龙江哈尔滨150081 [2]黑龙江省公共健康安全及医改策略研究高端智库

出　　处：《中国公共卫生》2022年第2期134-138,共5页Chinese Journal of Public Health

基　　金：国家自然科学基金(71874044,71473065)。

摘　　要：目的构建灾难性医疗需求激增情境下卫生系统韧性的评价指标体系,为提高中国灾难风险管理能力提供参考依据。方法采用德尔菲专家咨询法构建基于熵理论的灾难性医疗需求激增情境下卫生系统韧性评价指标体系,采用Saaty's权重法确定指标的权重。结果专家咨询的积极系数为81.6%;一级指标、二级指标和三级指标的权威系数分别为0.89、0.76和0.85,协调系数分别为0.352、0.301和0.260(均P<0.05);经专家咨询后,最终确定了由2个一级指标、9个二级指标和35个三级指标构建的灾难性医疗需求激增情境下卫生系统韧性评价指标体系。一级指标中,"卫生系统供给能力与激增医疗需求的平衡"的权重系数最高(0.7500);二级指标中,"紧急医疗服务"的权重系数最高(0.4476);三级指标中,"危急重症监护室人员储备满足激增医疗需求程度"的权重系数最高(0.0799)。结论构建的灾难性医疗需求激增情境下卫生系统韧性评价指标体系具有科学性和可靠性,可为我国灾难风险管理能力的提高提供参考依据。Objective To construct an index system for the evaluation on health system resilience in the context of catastrophic medical surge and to provide references for improving medical institutions'disaster risk management capability in China.Methods An entropy theory-based framework of the index system was primarily constructed through literature studies;then an online Delphi consultation was conducted among 31 domestic experts with at least ten years'experiences in health emergency management/disaster medicine-related research/teaching/administration during September–November,2020.Saaty's weight method was adopted to calculate weight coefficients of the indexes in the evaluation system.Results The positive coefficient was 81.6%for the expert consultation;for the first-,second-,and third-level indicators included in the evaluation system,the authoritative coefficients were 0.89,0.76,and 0.85 and the coordination coefficients were 0.352,0.301,and 0.260,respectively(all P<0.05).The finally established evaluation index system included 2 first-,9 second-,and 35 third-level indicators.The first-level indicator with the highest weight coefficient(0.7500)was for the balance between a health system's supply capacity and the demand of a catastrophic medical surge;the second-level indicator with the highest weight coefficient(0.4476)was for emergency medical services;and the third-level indicator with the highest weight coefficient(0.0799)was for the professional resources of intensive care unit against the demand of a catastrophic medical surge.Conclusion The established index system for the evaluation on health system resilience in the context of catastrophic medical surge is valid and reliable and could be preliminarily used in promoting public health risk management capability in China.

关 键 词：卫生系统韧性 评价 指标体系 需求激增 灾难性医疗 德尔菲专家咨询法 

分 类 号：R181.1[医药卫生—流行病学]